Scrub Typhus Differential Diagnoses

Updated: Sep 29, 2023
  • Author: David J Cennimo, MD, FAAP, FACP, FIDSA, AAHIVS; Chief Editor: Russell W Steele, MD  more...
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Diagnostic Considerations

Scrub typhus may rarely be first seen with fever and a tender neck swelling, mimicking a deep neck infection. [48]

Diagnosing scrub typhus in international travelers can be challenging. [13, 33] Such travelers may become sick before or within a few days of return from an endemic region. An illness that begins more than 18 days after return is unlikely to be scrub typhus. If empiric therapy does not result in defervescence within 48 hours, an alternative diagnosis should be strongly considered. Travelers to endemic areas should be educated regarding the importance of being aware of bites and seeking treatment immediately if they are affected.

Differential Diagnoses